Mission Statement:
To deliver various components of the Nuu chah nulth Non-Insured Health Benefits (NIHB) in coordination with community development/initiatives, and provincial agencies/resources. To test future management options for the delivery of the NIHB programs in a manner that is conducive to an effective and efficient information process.
This document is designed
to pass on Non-Insured Health Benefit information
to Nuu chah nulth communities. My contact
with the communities and Medical Services
Branch, Vancouver, keeps me up to date on
changes that affect NIHB. This contact will
help me inform the First Nations CHR or Health
Clerk on changes to benefits. The developments
created in our communities at this time of
transfer, will determine the future of our
NIHB program.
Contact Number - 1 888
407-4888
Robert Cluett
NTC CHS NIHB Program Coordinator, May 2002
email: cluett@nuuchahnulth.org
Patricia Little
NIHB Accounts Payable
email: tricial@nuuchahnulth.org
Bella
Fred
NIHB Clerk
email: bella@nuuchahnulth.org
Optical Program
Medical Patient
Travel
Mental Health Services
Medical Equipment and Supplies
Dental
Pharmacy
Status Card/Care Card/Medic Alert/CNIB
Optical Program
Eyeglasses Replacement
- Minimum change of .5 diopter to change eyeglasses
- High index (thinner lenses) 7.00 diopters
or more - The NTC CHS NIHB Program (cost may
be lower than what is charged)
-24 months for 18 years and up
-12 months for 17 and under
- Physiological change related to physical need
Eye Exam frequency and Care Card
- Eye examinations limited to once every 24 months. The limit does not
apply to persons under 19, over 65, or with a medical condition requiring
more frequest examinations
- The NTC CHS Program now pays a maximum of $44.83 for eye exams for
persons between the age of 19 and 64. Eye specialists and Optometrists
may charge a range of $90 to $120 per exam.
Contact Lenses
- Hard Lens may be approved under the following
criteria:
- Aphakia (post cataract surgery)
- Cornea Irregularities
- Astigmatism (inadequately corrected by eyeglasses)
Contact Lens for cataract surgery falls under medical care plan and
currently only approves the hard lens as a replacement. There is a new
state-of-the-art soft acrylic lens with a current cost of $300 per eye.
For CNIB (Canadian National Institute for the Blind) contact Vancouver
Island District at (250) 595-1100
Medical Patient Travel
Community Level Patient Travel has to be accessed through the
Community where you are resident. Away from home travel is
administered through through your current
community and they will
access re-imbursement through the NIHB Program at NTC.
The NTC Basic Medical Transportation Policy sets out minimum benefits
that must be provided to all Nuu chah nulth
and members of other
First Nations normally resident in their community.
NIHB NTC has a contract with the local Port Alberni Friendship Centre
(PAFC) to administer Medical Travel for NFN Clients within Port Alberni
area.
The Medical Transportation Policy covers only "medically and legally"
required travel expenses for the client and as medically required escorts.
The current minimum mileage is 25 cents per kilometre.
Away from home travel requests administered through your community
office will be reimbursements from NTC NIHB. Reimbursements will be
strictly in accordance with the NTC Basic Medical Transportation Policy.
Coordination of benefits is strongly enforced with other agencies, and
only provided when a client signs a form assigning benefits to the
First Nation in the amount of the assistance provided.
A client who feels the decision made within the NTC NIHB CHS Policy
are unjust to them have a right to appeal these decisions by going
through the process in the policy and their
community appeal panel. Contact your current
community for further details.
Mental Health
Program under agreement with First Nations and Inuit Health Branch
Medical Equipment and Supplies
-Under administration and operation of FNIHB (1-800-317-7878)
-Requires a medical prescription, and if required an assessment to be forwarded to the appropriate provider for onward transmission to FNIHB Vancouver Zone for predetermination.
-Lifeline phone and monthly payment are not a benefit under NIHB Program
Dental
-Under administration and operation of FNIHB
(1-800-317-7878)
-Does not cover for cosmetics
-Assistance given for Dental Braces coverage
up to a maximum of $5500 when approved, if cavity free for
6 months
-Community prevention is strongly encouraged if there is a reasonable chance of transferring this program and staying within budget. A highly volatile and cost driven program
Pharmacy
-Under the administration and operation of FNIHB Vancouver Zone
-The Prescription Drug Exception Centre is in Ottawa
-When brand-name and generic versions of the
same drug are available, the NIHB program
will pay for whichever drug has the lowest
price. Generic drugs contain the same main
ingredient as the brand-name original. Hospitals
know the value of generic drugs, they have
been using them for years instead of the more
expensive brand-name drugs
-If a prescription is denied through the National NIHB Program you have the right to appeal this decision. the appeal begins with the Pharmacist advocating by sending an appeal electronically on a clients behalf to the Drug Exception Centre (DEC) Ottawa. they will in turn decide if they will process it through the clients family doctor requesting justification for the prescription medicine. the doctor completes a specific form and returns it to DEC Ottawa for a final consideration, at which time they will inform your pharmacy of the decision
Care
Card
Call 1-800-663-7100 or visit BC MSP Care Card web site.
Medic Alert
Client gets an application from Band Office or their doctor's office
and completes the form and forwards form to:
Non-Insured Health Benefits
Indian and Inuit Health Services
510-757 West Hastings St
Vancouver, BC
V6C 1A1
CNIB
The Canadian National Institute for the Blind (CNIB) is a voluntary,
not for profit organization that provides services to anyone with a
visual impairment, which cannot be corrected by ordinary lenses.
CNIB is not a government agency. Thousands of people receive
services from professional staff supported by volunteers within BC
and the Yukon.
The CNIB Program offers the following services that are intended to
minimize the effects of visual impairment and to learn from others
who have had similar experiences:
-Counseling and Referral (Adjustment to Vision Loss)
-Rehabilitation Teaching (Enhancing Life and Skills)
-Career and Employment Counseling (Find Work)
-Orientation and Mobility (Learning Safe Travel)
-Technical Aids Service (Simple Product Solutions
-Library Services (Access to Information)
-Public Education (Brochures and Videos)
-Volunteer Services (Support and Assist)
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